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Open Access 01-12-2019 | REVIEW

The application of fluorescence techniques in meningioma surgery—a review

Authors: Bianca M. Dijkstra, Hanne-Rinck (J.R.) Jeltema, Schelto Kruijff, Rob J. M. Groen

Published in: Neurosurgical Review | Issue 4/2019

Abstract

Surgical resections of meningiomas, the most common intracranial tumor in adults, can only be curative if radical resection is achieved. Potentially, the extent of resection could be improved, especially in complex and/or high-grade meningiomas by fluorescence-guided surgery using 5-aminolevulinic acid (5-ALA), indocyanine green (ICG), or fluorescein. This review aims to summarize and evaluate these fluorescence-guided meningioma surgery techniques. PubMed and Embase were searched for relevant articles. Additionally, we checked reference lists for further studies. Forty-eight articles were included in the final analysis. 5-ALA fluoresced with varying sensitivity and selectivity in meningiomas and in invaded bone and dura mater. Although ICG was mainly applied for video angiography, one report shows tumor fluorescence 18–28 h post-ICG injection. Lastly, the use of fluorescein could aid in the identification of tumor remnants; however, detection of dural tail is highly questionable. Fluorescence-guided meningioma surgery should be a reliable, highly specific, and sensitive technique. Despite numerous studies reporting the use of fluorescent dyes, currently, there is no evidence that these tools improve the radical resection rate and long-term recurrence-free outcome in meningioma surgery without neurological deficits. Evidence regarding the effectiveness and increased safety of resection after the application of these fluorophores is currently lacking. Future research should focus on the development of a meningioma-targeted, highly sensitive, and specific fluorophore.

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Title: The application of fluorescence techniques in meningioma surgery—a review
Authors: Bianca M. Dijkstra
Hanne-Rinck (J.R.) Jeltema
Schelto Kruijff
Rob J. M. Groen
Publication date: 01-12-2019
Publisher: Springer Berlin Heidelberg
Published in: Neurosurgical Review / Issue 4/2019
Print ISSN: 0344-5607
Electronic ISSN: 1437-2320
DOI: https://doi.org/10.1007/s10143-018-01062-4

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

The application of fluorescence techniques in meningioma surgery—a review

Abstract

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Abstract

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